Ms Barbara O'Connell:

I will start with people in nursing homes. When you bring it down to an individual level, nursing homes are set up to care, so it is a case of them dressing you regardless of whether you can dress yourself or not. Even if I can pull on my own clothes, they will be put on for me. My tea will be put in front of me. I will not have the opportunity to boil a kettle and make my own cup of tea. There is a level of perpetual dependence in such a setting that must be undone when you take somebody out of it.

The reason people like being in a nursing home setting is often because they have medical and nursing needs. We assessed somebody in a nursing home who was being fed his dinner and was being dressed. We took him out and he went to the local pub for a pint and had no problem drinking the pint of Guinness. He had no problem putting it to his own mouth and drinking it. You realised that this man could drink himself. Why was this? It was because he was in a normal setting and did what he normally needed to do. That was the opening key for asking what else he could do. This particular gentleman moved out of that nursing home and started washing and dressing himself independently and going independently going into the community. He had no problem going to the pub for his pint. He needed the support of an assisted living residence in which he lived with three other people but he lived a completely full life. The key was the fact that somebody at some point said "lets see what you can do with that drink yourself". There is something about the environment in which you live that enables you to do more.

The example I have regarding housing is where the houses provided by Anvers Housing Association provides are in a normal residential community. There is one house where four of them lived and there are two houses scattered within the same locality where people moved to from that house. They are integrated into the community and are part of the residents' association. They are no different from anybody else and it is a model that really works. Going back to my point, it is just not replicated. You cannot get it everywhere. Obviously, the housing crisis is not necessarily helping that but we know what to do. We must look at the environment in which people live in order to enable them.

It goes back to the enablement model and not creating that dependency. It also involves not putting so many one-bedroom apartments together. They should be integrated as much as possible. If you have universal design, that happens automatically. If my rooms are big enough and accessible, I can buy a house anywhere, I can live anywhere and there is much more flexibility.

The committee spoke about implementation strategies. There is a brilliant neuro-rehabilitation strategy with a case management pathway so there is one point of contact that takes the person all the way along. It can be replicated in other areas for other types of people but if we could just get it funded and implemented, it would be significant. The strategies have been consultative and lay out really good pathways but they are not being implemented.